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SITUATION REPORT | Issue 13 | 22-28 February 2015

IOM Sierra Leone Ebola Response

IOM’s National Ebola Training Academy has now trained over 4,000 health care workers as of 28 February. A week long mobile training course is ongoing in Bombali district for two teams of 27 decontamination workers.

IOM’s Health and Humanitarian Border Management team

successfully concluded a second Emergency Simulation Exercise on 23 February. The team will now lead a rapid two day border assessment to Kambia district on 2-3 March involving a number of government and UN agencies. Four additional rapid assessment missions will be held during March.

IOM continues interim home care kit distribution through

implementing partner, Oxfam’s in the Western Area in, with a

total of 202 kits distributed to date. IOM and its’ implementation

partners, Oxfam and ACF, held a lessons-learned meeting on 24

February. The objectives were to spread best-practices and

increase the responsiveness of distribution to epidemiological

trends.

IOM and World Hope International’s social mobilization pillar

support teams in Bombali district continue intensive community

engagement in Rosanda in Paki Masabom chiefdom and Kapethe in

Biriwa chiefdom. As an Ebola hotspot, ten homes have been

quarantined in Rosanda and the entire village of 36 homes was put

under isolation on 25 February. In the past 72 hours there has been a

spike of 31 cases in the area.

HIGHLIGHTS SITUATION OVERVIEW The steep decline in case incidence nationally in Sierra

Leone from December until the end of January has halt-ed. Weekly case incidence has stabilized at between 60 and 100 confirmed cases. A total of 63 cases were report-ed in the week to 22 February. The total for the previous week has been revised up to 96 confirmed cases, after missing laboratory data was included. Transmission re-mains widespread, with 8 districts reporting new con-firmed cases. A significant proportion of cases are still arising from unknown chains of transmission.

There has been a sharp increase in reported confirmed cases in the northern district of Bombali, with 20 con-firmed cases reported in the week to 22 February. The outbreak is reportedly linked to the cluster of cases in the Aberdeen area of Freetown. A response team con-tinues to trace and monitor over 2000 contacts associat-ed with the cluster. The neighbouring districts of Kambia (8 confirmed cases) and Port Loko (15 confirmed cases) also report persistent transmission. The capital, Free-town, reported 14 new confirmed cases.

Transmission is also reported in several other regions of the country, including the eastern districts of Kenema and Kono, which each reported 1 case in the week to 22 Feb-ruary.

In the 3 days to 19 February, a total of 9 confirmed cases were identified after post-mortem testing of dead bodies found in the community indicating that a significant num-ber of individuals are still either unable or reluctant to seek treatment.

© IOM 2015 © OFDA 2015

Dr Desmond Maada Kangba of IOM’s Training Academy in Freetown stresses correct Infection Prevention and Control procedures

during the second Emergency Simulation Exercise held at Lungi Airport on 23 February.

© IOM 2015

IOM Sierra Leone Ebola Response Situation Report | Issue 13 | 22-28 February 2015

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National Ebola Training Academy & Mobile Training

Operational Highlights One 3+2 day clinical Infection Prevention and Control simulated patient training course was held for trainees from the Police Training School, the Ministry of Health and Sanitation, Connaught Hospital and the Adventist Development and Re-lief Agency International (ADRA).

Deployment of one 4 person rapid response mo-bile team to Makeni in Bombali district to train 27 members of two house decontamination teams is ongoing. The teams are being guided through a 5 day course which includes 2 days of IPC, 2 days of decontamination and 1 day of prac-tical home decontamination.

Two 3 day basic IPC courses were held for 292 stu-dents from, the 34th Military Hospital, Wesleyan Hos-pital, the Marbella Community Health Centre,

Gbanalol Holding Centre, Rokupa Government hos-pital, ADRA, Lakka Government Hospital, the Ola During Children’s Hospital, the Police Training School and the Ministry of Health and Sanitation.

Cumulative Training Academy operational data for 01 December 2014– 28 February 2015 (weekly number in brackets)

Course Name Number of courses run

Total number of National students

Total number of International Students

Cumulative Total

3 day Ebola clinician IPC 2 day simulated patient

11 (1)

245 (30)

300 (13)

545

1 day Ebola clinical IPC 2 day simulated patient

4 26 59 85

1 day clinical augmentation

2 25 41 66

3 day basic IPC/PPE 34 (2) 3079 (292) 49 3128

Mobile Training I day IPC

5 (1) 202 (27) 0 202

Total 56 (3) 3577 (349) 449 (13) 4026

Jasmine Riley, Training Coordinator, prepping Academy staff

for interviews with the British Forces Broadcasting Service.

© IOM 2015

Clinical care vs. Infection Prevention and Control Trainees by profession

IOM Sierra Leone Ebola Response Situation Report | Issue 13 | 22-28 February 2015

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Emergency Care Kits

IOM and implementation partners, Oxfam and ACF, held a

meeting on 24 February 2015. The objectives were to

share and document lessons-learned from the current

project to spread best-practices, increase the responsive-

ness of distribution to epidemiological trends and to de-

termine ways forward. 25 Community Health Workers,

members of Community Health Committees

(CHCs), field staff, coordinators, and project

managers were in attendance to ensure a

broad sharing of views and experiences. High-

lights included improving uniformity of ap-

proach, including the criteria for kit distribu-

tion and accessing quarantined households.

Strategies on how to respond to current and

future trends in transmission were also dis-

cussed including expanding geographical cov-

erage, working more closely in support of

community-based health systems, and better

response for quarantined areas.

Oxfam continues interim home care kit distri-

bution through their community-based active

case finding activities in the Western Area in seven wards,

with a total of 202 kits distributed to date. Oxfam’s teams

are meeting with the Western Area District Health Man-

agement Team (DHMT) to liaise on contingency planning

and preparedness in the Western Area, specifically in

Oxfam’s areas of operation which includes 11 peripheral

health units (PHUs).

Health & Humanitarian Border Management

On 23 February IOM's Border Management Team held the second Emergency Simulation Exercise at Lungi Interna-tional Airport. As a vulnerable yet extremely important asset to the continued economic livelihood of Sierra Leo-ne, the airport's necessity as a transport hub is unparal-

leled. There-fore regular Emergency Simulation Exercises are an essential training tool for airport staff to en-sure their own safety along with the security of the air-port facility and its pas-sengers, while en-hancing

their knowledge and responsiveness. The exercise was made up of three pre-planned scenarios and employed IOM expert patients, who are Ebola survi-vors, from the IOM Training Academy in Freetown to add realism to the activities. As with the first exercise on 12 January, a number of areas for improvement were highlighted including the need for

IPC and Clinical training courses that better reflect the unique environment of the airport site. The HHBM team is linking with Academy to fill this need. Nevertheless, since the initial exercise the airport staff- security guards, cleaners, doctors, front gate health care workers, and IOM monitors- made major improvements in both preparedness and response time. From Monday, 2 March, the HHBM project manager is leading a rapid border assessment team made up of multi-sector stakeholder experts. This pilot assessment will tar-get land border crossing points in Kambia district. The as-sessment, broken down into five areas, includes district and community focus group discussions, and WASH, tech-nical IBM and health facility investigations. Once completed, the refined from the results of the Kam-bia mission the rapid assessment model will be used to investigate the land borders of other districts in Sierra Leo-ne. These assessments will provide the foundation for up-coming HHBM initiatives to get to zero Ebola cases while reinforcing border security.

© IOM 2015

© IOM 2015 IOM, Oxfam and ACF lessons-learned meeting held on 24 February to

discuss responsiveness of distribution to the latest transmission trends.

© IOM 2015

© IOM 2015

Cleaners wearing PPE move to

decontaminate a surface during the

simulation.

© IOM 2015

© IOM 2015

© IOM 2015

Security guard responds to suspected Ebola case

during emergency exercise.

© IOM 2015

IOM Sierra Leone Ebola Response Situation Report | Issue 13 | 22-28 February 2015

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For more information on IOM’s Sierra Leone activities please contact:

IOM Department of Operations and Emergencies | ebolaresponse@iom.int |

IOM Sierra Leone Response | jbaker@iom.int | Public Information/Project Development | nbishop@iom.int

Please find IOM Sierra Leone on Facebook at www.facebook.com/iomsierraleone

IOM Sierra Leone’s initiatives are supported by:

Social Mobilization targets Bombali flare up

This week at the Kono District Emergency Response Cen-ter’s (DERC) Social Mobilization Pillar meeting, Wellbody Alliance’s team of field Community Health Workers (CHWs), were commended for their initiative to decom-mission two Community Care Centers (CCCs). The CHWs traced seven contacts of an Ebola case to a remote village, inaccessible by ambulance, and supported them to move to a house in Koidu city, where they are under observa-tion. CHWs are monitoring and supporting the seven and will continue to do so until the 21 day period where they may develop symptoms of Ebola has passed. The Kono CHWs are beginning to shift into health messaging to-wards long-term health system strengthening. CHWs are finding increasing numbers of persons with general health problems, in addition to those suspected of Ebola. The CHWs are focused on rebuilding social support and refer-ral to community-based care, in particular for HIV/AIDS and tuberculosis patients. IOM and World Hope International’s social mobilization pillar support teams in Bombali district have continued intensive community engagement in Rosanda in Paki Masabom chiefdom and Kapethe in Biriwa chiefdom. Last week an infected fisherman from a quarantined com-munity in Freetown sought treatment from traditional healers in his home village of Rosanda in Bombali district near Makeni. Unfortunately, shortly thereafter the man passed away

and the community experienced a spike of 31 new Ebola cases within 48 hours. The village and neighbouring area has been placed under strict quarantine and the army has been deployed. On Sunday, March 1, IOM staff visited the village which is now said to have 46 cases with 10 deaths in the past two days where tragically, a single household has lost five fam-ily members. IOM and World Hope International are re-sponding with social messaging focused on infection pre-vention and control, staying safe while you wait at home and hy-giene promo-tion.

News Headlines (click links for story/video):

Sierra Leone village in lockdown after 31 new cases recorded, Guardian, 27 February Flare up of virus outside of Makeni with WHO linking cases to man who escaped quarantine in Freetown.

Ending the Ebola outbreak, NY Times, 24 February Months of declining cases have fed hopes that the Ebola outbreak might finally be ending.

Sierra Leone eyes post Ebola recovery, Financial Times, 25 February

In Sierra Leone Ebola survivors begin to find acceptance, UNICEF, 23 February

People with disabilities look to an Ebola-free future, All Africa, 24 February

Red Cross Ebola soap opera engages and educates communities, IFRC, 24 February

Sierra Leone mining sees revival after Ebola wanes, Bloomberg, 25 February

Sierra Leone quarantines Ebola-hit orphanage, Japan Times, 24 February

Social mobi-

lizers in Rosan-

da village, Bom-

bali responding

to Ebola spike.

© IOM 2015